在低等级中介风险NMIBC监测中与膀EpiCheck®交替囊检查:成本比较模型
Yair Lotan1, Georgios Gakis2, Matteo Manfredi3
1Department of Urology, UT Southwestern Medical Center, Dallas, TX, USA.
Bladder cancer (Amsterdam, Netherlands)
|July 12, 2024
概括
交替膀EpiCheck尿液标记测试与囊镜为非肌肉侵入性膀癌 (NMIBC) 患者提供了成本有效的监测策略. 这种方法在标记物价格适当时,在美国和欧洲证明成本相当.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 卫生经济学 卫生经济学
- 在瘤学瘤学.
背景情况:
- 膀癌监测方法具有侵入性,密集性和成本.
- 患有低度中等风险非肌肉侵入性膀癌 (NMIBC) 的患者面临复发的高风险.
研究的目的:
- 为了比较监测策略的成本效益,与标准监测协议相比,交替的囊镜与膀EpiCheck尿液标记器.
主要方法:
- 使用TreeAge Pro Healthcare开发了一个决策树模型,以模拟2年监测结果.
- 关于复发率的数据来源于现有文献.
- 从美国和9个欧洲国家收集了成本数据;进行了敏感性分析.
主要成果:
- 这两种监测策略均表现出同等的有效性,中位数复发率为22%.
- 在美国,荷兰,瑞士,比利时,意大利,奥地利和英国,当标记器成本为200欧元时,膀EpiCheck臂更具成本效益.
- 标价在148欧元至421美元之间实现了成本平价;标价和特异性显著影响了总体成本.
结论:
- 交替膀EpiCheck与囊镜是美国和欧洲NMIBC监测的成本相当的策略,前提是由于其高特异性 (86%),标记物的价格在148欧元至421美元之间.
- 需要进一步的前性研究来验证这些经济发现.
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